Will there be a 'real' CMS administrator soon? It's looking so

If you're a gambling person, it looks like the odds just got a whole lot better for Marilyn Tavenner becoming the next administrator of the Centers for Medicare & Medicaid Services. That's the person who manages the main funding streams of long-term care in the United States.

Senate Finance Committee Chairman Max Baucus announced Tuesday that his panel would hold a hearing on her nomination next Tuesday. That's right after Congress returns from its Easter recess, not exactly the time you would expect someone to be fed to the lions.

That's not to say political adversaries, of both Tavenner and President Obama, won't come out swinging. The punches and follow-through just might not be as hard as for other White House nominees. Tavenner is said to have broad support across party lines, including from House Majority Leader Eric Cantor (R-VA), who has endorsed her nomination.

In simply announcing a hearing date, Baucus went farther than he ever did with Tavenner's predecessor, Donald Berwick, M.D. Berwick served as acting CMS administrator via an Obama recess appointment. But because of Republican threats to derail the nomination, a confirmation hearing was never held and Berwick never got past the “acting administrator” title.

In fact, Tavenner didn't get a confirmation hearing last year when Obama first nominated her. That was during an election year, however, when the administrations still was sweating out a re-election run and, for much of the year, what the Supreme Court would rule on the health reform law.

So what would a fully approved Tavenner appointment mean for long-term care? Probably more of the same. She has, after all, been acting CMS administrator since late 2011, and the White House isn't switching hands any time soon.

Long-term care provider associations have said nice things about her and said they would work well with her. Of course, one could expect nothing but such niceties from lobbying organizations that will need to be on good terms with their employers' main financier.

The last 13 years have been a rancorous, gap-ridden period for CMS leaders. There have been no fewer than 11 (counting Tavenner) “acting” administrators. During the same period, there were just two administrators confirmed by Congress, each sticking around for only two years.

Given that tumult and uncertainty, a quick confirmation of Tavenner would be a welcome development. That goes for providers, as well as others who yearn for stability.

The hearing will start at 9 a.m. Tuesday in Room 215 of the Dirksen Senate Office Building. It also will be broadcast live, according to officials.

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